Skip to main content
American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2010 Mar;25(2):142–148. doi: 10.1177/1533317509333904

Evaluation of Dementia Rating Scales in Parkinson’s Disease Dementia

Philip D Harvey 1, Steven H Ferris 2, Jeffrey L Cummings 3, Keith A Wesnes 4, Chuanchieh Hsu 5, Roger M Lane 6, Sibel Tekin 7
PMCID: PMC10845539  PMID: 19359706

Abstract

Disease-specific assessments are not currently available for patients with Parkinson’s disease dementia (PDD). This study evaluated the criterion-related validity and test—retest reliability of the Alzheimer’s Disease Assessment scale cognitive subscale (ADAS-cog) in terms of sensitivity for differentiation between mild and moderate severity impairment in PDD. Six other dementia rating scales and cognitive tests were also examined. A total of 113 patients with PDD or Alzheimer disease were recruited into this 4-week, multicenter study, segregated into 2 severity groups based on Mini-Mental State Examination (MMSE) score. Mean ADAS-cog scores showed a statistically significant separation between mild and moderate severity patients in both dementias (P < .001). For the ADAS-cog, test—retest Spearman correlation coefficients were significant for each dementia type and severity. This study demonstrated the criterion-related validity and test—retest reliability for ADAS-cog in patients with PDD and strong correlations with MMSE. This supports the validity of previous results obtained with these measures in studies of patients with PDD.

Keywords: dementia assessment scales, Parkinson’s disease dementia, validity, reliability

Full Text

The Full Text of this article is available as a PDF (162.5 KB).

Contributor Information

Philip D. Harvey, Emory University School of Medicine, Atlanta, GA, USA, philipdharvey1@cs.com .

Steven H. Ferris, Alzheimer's Disease Center, New York University School of Medicine, Nathan Kline Institute Orangeburg, New York, USA.

Jeffrey L. Cummings, Mary S Easton Center for Alzheimer's Disease Research at UCLA, Los Angeles, CA, USA.

Keith A. Wesnes, Cognitive Drug Research Ltd, Goring-on-Thames, UK.

Chuanchieh Hsu, Novartis Pharmaceuticals, East Hanover, NJ, USA.

Roger M. Lane, Novartis Pharmaceuticals, East Hanover, NJ, USA.

Sibel Tekin, Novartis Pharmaceuticals, East Hanover, NJ, USA.

References

  1. Plassman BL, Langa KM, Fisher GG, et al. Prevalence of dementia in the United States: the aging, demographics, and memory study. Neuroepidemiology. 2007;29(1-2):125-132. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Farlow MR, Cummings J. A modern hypothesis: the distinct pathologies of dementia associated with Parkinson’s disease versus Alzheimer’s disease. Dement Geriatr Cogn Disord. 2008;25(4):301-308. [DOI] [PubMed] [Google Scholar]
  3. Ferris S. Clinical trials in AD: are current formats and outcome measures adequate? Alz Dis Assoc Disord. 2002; 16(suppl 1):13-17. [DOI] [PubMed] [Google Scholar]
  4. Emre M., Aarsland D., Albanese A., et al. Rivastigmine for dementia associated with Parkinson’s Disease. New Engl J Med. 2004; 351(24):2509-2518. [DOI] [PubMed] [Google Scholar]
  5. Dubois B., Tolosa E., Kulisevsky J., et al. Efficacy and safety of donepezil in the treatment of Parkinson’s disease patients with dementia. Poster presented at: 8th International Conference on Alzheimer’s and Parkinson’s Diseases; March 14-18, 2007: Salzburg, Austria. [Google Scholar]
  6. Janvin CC, Larsen JP, Salmon DP, Galasko D., Hugdahl K., Aarsland D Cognitive profiles of individual patients with Parkinson’s disease and dementia: comparison with dementia with Lewy bodies and Alzheimer’s disease. Mov Disord. 2006;21(3):337-342. [DOI] [PubMed] [Google Scholar]
  7. Brønnick K., Emre M., Lane R., Tekin S., Aarsland D Profile of cognitive impairment in dementia associated with Parkinson’s disease compared with Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2007. ;78(10):1064-1068. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Emre M., Cummings JL, Lane RM Rivastigmine in dementia associated with Parkinson’s disease and Alzheimer’s disease: similarities and differences. J Alzheimers Dis. 2007;11(4):509-519. [DOI] [PubMed] [Google Scholar]
  9. Press DZ Parkinson’s disease dementia-a first step? New Engl J Med. 2004;351(24):2547-2549. [DOI] [PubMed] [Google Scholar]
  10. Rosen WG, Mohs RC, Davis KL A new rating scale for Alzheimer’s disease. Am J Psychiatry. 1984;41(11):1356-1364. [DOI] [PubMed] [Google Scholar]
  11. Cummings JL , Mega M., Gray K., Rosenberg-Thompson S., Carusi DA, Gornbein J The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44(12):2308-2314. [DOI] [PubMed] [Google Scholar]
  12. Galasko D., Bennett D., Sano M., et al. An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. Alzheimer Dis Assoc Disord . 1997; 11(suppl 2):S33-S39. [PubMed] [Google Scholar]
  13. Delis D., Kaplan E., Kramer JH The D-KEFS Examiner’s Manual. San Antonio, TX: The Psychological Corporation; 2001. [Google Scholar]
  14. Reitan RM, Wolfson D The Halstead-Reitan Neuropsychological Test Battery. Tucson: Neuropsychology Press; 1985. . [Google Scholar]
  15. Manos PJ Ten-Point Clock Test sensitivity for Alzheimer’s disease in patients with MMSE scores greater than 23. Int J Geriat Psychiatry. 1999;14(6):454-458. [PubMed] [Google Scholar]
  16. Wesnes KA Assessing change in cognitive function in dementia: the relative utilites of the Alzheimer’s Disease Assessment Scale-Cognitive Subscale and the Cognitive Drug Research system. Neurodegener Dis. 2008;5(3-4):261-3. [DOI] [PubMed] [Google Scholar]
  17. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed Washington, DC: American Psychiatric Association; 1994. [Google Scholar]
  18. McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan EM Clinical diagnosis of Alzheimer disease: report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer’s disease. Neurology. 1984;34(7):939-944. [DOI] [PubMed] [Google Scholar]
  19. Hughes AJ, Daniel SE, Kilford L., Lees AJ Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992; 55(3):181-184. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Folstein M. , Folstein S., McHugh P. Mini-Mental state. A practical method for grading the cognitive state of patients for the clinician . J Psychiatr Res. 1975;12(3):189-198. [DOI] [PubMed] [Google Scholar]
  21. Reisberg B. , Ferris SH, Leon MJ, Crook T The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry . 1982;139(9):1136-1139. [DOI] [PubMed] [Google Scholar]
  22. Cohen J. Statistical Power Analysis for the Behavioural Sciences. New York, NY: Academic Press; 1977. . [Google Scholar]
  23. Cohen J. Statistical Power Analysis for the Behavioural Sciences. 2nd ed Hillsdale, NJ: Erlbaum; 1988. [Google Scholar]
  24. Bohnen NI, Kaufer DI, Ivanco LS, et al. Cortical cholinergic function is more severely affected in parkinsonian dementia than in Alzheimer disease: an in vivo positron emission tomographic study. Arch Neurol. 2003;60(12):1745-1748. [DOI] [PubMed] [Google Scholar]
  25. Emre M. Dementia associated with Parkinson’s disease. Lancet Neurol. 2003;2(4):229-237. [DOI] [PubMed] [Google Scholar]
  26. Bullock R., Lane R Executive dyscontrol in dementia, with emphasis on subcortical pathology and the role of butyrylcholinesterase. Curr Alzheimer Res . 2007;4(3):277-293. [DOI] [PubMed] [Google Scholar]
  27. Braak H., Braak E. Evolution of neuronal changes in the course of Alzheimer’s disease. J Neural Transm Suppl. 1998;53: 127-140. [DOI] [PubMed] [Google Scholar]
  28. Riedel O., Klotsche J., Spottke A., et al. Cognitive impairment in 873 patients with idiopathic Parkinson’s disease. Results from the German Study on Epidemiology of Parkinson’s Disease with Dementia (GEPAD). J Neurol. 2008. ;255(2):255-264. [DOI] [PubMed] [Google Scholar]
  29. Zadikoff C. , Fox SH, Tang-Wai DF, et al. A comparison of the mini mental state exam to the Montreal cognitive assessment in identifying cognitive deficits in Parkinson’s disease. Mov Disord. 2008;23(2):297-299. [DOI] [PubMed] [Google Scholar]
  30. Nasreddine ZS, Phillips NA, Bédirian V., et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment . J Am Geriatr Soc. 2005;53(4): 695-699. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Alzheimer's Disease and Other Dementias are provided here courtesy of SAGE Publications

RESOURCES